Sunday, June 30, 2013

What Would Osler Say?

There is a certain feeling of disenfranchisement among those of us who were present during the infancy of healthcare social media.  Before the days of twitter, the players were few, the interactions meaningful, and the main mechanism of change was a quaint self publishing tool called a weblog. 

We were out to rule the world. Blogs were well written and lengthy.  The expectation was that the comment section would be just as lively as the post itself.  There were no book deals, TED talks, or media interviews.  We were a group of whipper-snappers, bucking the system, and blazing the trail.

The advent of twitter and facebook brought welcome improvements.  Our opinions were amplified.  Our numbers grew.  And amazingly enough, the rest of the world took notice.  We were no longer just a group of disgruntled docs.  Patients, advocates, and allied healthcare professionals also joined our ranks. 

The winds of change, however, are indifferent to mourning for the past.  Our sacred space became cluttered not only with content, but also self promotion.  Blogs became shorter and to the point.  Comments were slung at each other in small word size tidbits that often lost the subtlety of artful communication.  The noise became at times unbearable. 

We see this same type of change happening in the practice of clinical medicine.  We use terms like "creative destruction" and "disruptive innovation" to describe what medical futurists must see as the brave new world of healthcare delivery.  But I fear that we run the risk of throwing the baby out with the bath water.  In other words, quantified self, big data, accountable care organizations, and the electronic revolution must seek to add and not replace our current infrastructure. 

In both medicine and social media, it would be complete and utter foolishness to actually destroy that which was built with the blood and sweat of our forebearers.

I would like to think that today's healthcare social media giants climbed on our backs not to push us down, but rather to reach better more lucid heights. 

I'm sure if Osler was around today, he would say much the same thing.


Maggie said...

I fear poor Osler is turning over in his grave. Having taught us the need to actually observe the patient and actually learn by doing, we are now confronted by students (both pre- and post-grad) learning by memorizing the protocols and not remembering to actually see the patient.

I'm so glad to have grown up in the age of competent, caring doctors at the same time as miracle drugs. Maybe our grandkids will have actual evidence for the evidence-based medicine they will be receiving.

Dr. A said...

You know, I'm so entrenched in the current health care system - keeping my head down and just getting the work done - that you're parallel of what's happening in hcsm and the medical system - this is spot on.

I've learned a lot from my self-imposed exile from health care social media. I'm still trying to find a way to express it and I'll be sharing A LOT of what I've been thinking soon.

One thing that I'll share is that there are A LOT of people out here in HCSM that feel the same way about the current health care social media landscape. I know, because they reached out to me in the past few weeks.

Thanks so much for writing a post about this. There is definitely an audience out there who feel the same way, but aren't saying anything. Let's keep bring up these thoughts, because it is only when it's mentioned more - this is when opportunities for dialogue take place. Well done!

Dr. A said...

I'm working so hard in this broken healthcare system - with my head down just trying to finish the work - that it never occurred to me to parallel healthcare social media to the current health care system.

I've learned a lot during my self-imposed social media exile, and I will share A LOT when I return full time to social media later this month.

But, there certainly is an audience out there who are concerned that health care social media has changed significantly in the past few years. I know there is an audience out there, because they reached out to me in the past few weeks.

Thanks for bringing up this topic. I think that we should continue to mention what we're feeling and our worries about the current health care social media landscape. It's only through more mentions, that potentially dialogue will take place. Well done!

DrPosDev said...

Osler has been turning over in his grave for a while. The humanism that drew many of us into healthcare has been replaced by financially-driven decision making by people saying healthcare is "just a business like any other." That isn't and can't be true, at least not entirely. There is a part of this that truly is a calling and we've shoved that into a corner as we strive to keep up with RVU's, shorten LOS, optimize and minimize variation, and apply other industrial frameworks. Works for widgets, not so well for people.

Howard Luks said...

Well said... It's an issue that I'm sure many wrestle with for a variety of reasons. I echo Mike's closing comments and share both of your concerns. FWIW :-)